GIANT CELL TUMOR OF DISTAL RADIUS CAMPANACCI GRADE 3 RECECTED AND RECONSTRUCTED BY ULNAR TRANSLOCATION A case report

Abstract

Giant cell tumor of bone (GCT) is a rare  aggressive benign tumor. It generally occurs in adults  between the ages of 30 and 40 years. Giant-cell tumor of the bone accounts for 4-5 percentage of primary bone tumors and 20 percentage of benign bone tumors with primary distribution around the knee rarely at the sacrum, proximal humerus and distal radius. The peculiar feature of the giant cell tumor is that it is more aggressive at the distal radius and it represents the third most common .Giant cell tumors of the distal radius have been frequently described as difficult to treat, chiefly because of their close proximity to multiple tendons, median nerve, radial artery and carpus. The aim of treatment is to remove the tumor completely and preserve the radiocarpal and radioulnar joints. Wide excision and reconstruction   particularly when the tumor breaks through the cortex,  violates the articular surface, and destroys 50 of the             surrounding metaphysis. Reconstruction by ulnar translocation though demanding provides an excellent result in an expert hand thereby preserving the pronation and  supination to a functional extent. Ulnar translocation has been mentioned rarely in the literature, and, according to our  knowledge, only few have been previously reported. We  present a case of 38 year old active male who is a gardner by occupation diagnosed with giant cell tumor of the right distal radius that was expansile and lytic involving 4 to 5 cm of the distal radius that was of campanacci grade 3.This case has been presented for the rarity of the procedure of ulnar           translocation and wrist arthrodesis that has been reported only in few numbers as far to our knowledge and the patient did not have any of the complication of nerve palsy infection, delayed union, loosening, recurrence but recovered well with a functional limb and preserved pronation and supination at a functional range on 2 years of follow up.